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To the Editor:
We read with interest the recent report by Kirchner et al.,1 which showed an analgesic effect of left vagus nerve stimulation (VNS) on tonic mechanical pain and mechanical “wind-up” pain, but not on mechanical impact pain or thermal pain. We previously reported a hyperalgesic effect of VNS on experimental thermal pain in subjects with previously implanted vagal nerve stimulators.2 In our study, thermal pain thresholds were measured when the stimulators were turned off, in the presence of varying intensities of VNS, and during a “sham” stimulus. Our subjects demonstrated a significant reduction of thermal pain thresholds in the presence of VNS. This is in contrast to Kirchner et al.,1 who studied patients before stimulator implantation and at two time points after implantation during the normal cycling of their stimulators. However, their tests of thermal pain and wind-up were performed in the presence and absence of VNS. We gathered, but did not report, some data that are similar to those of Kirchner et al.1 …
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